The Minister of Health, Isaac Adewole, says primary health care is not the responsibility of the federal government but that of local governments.
While the assertion draws support from the Constitution, it is, however, in conflict with the position of the Nigerian Senate, which on Tuesday called on the federal government to put primary health care facilities across the country in good shape.
The Senate made the call while noting a report by the World Health Organisation and UNICEF that over 2300 children under the age of five and 145 women die daily in Nigeria due to the poor state and inadequate number of primary health care facilities in the country.
The Senate asked its appropriation committee to ensure that funds are set aside to put primary health care centres across the country functional.
But speaking earlier in an exclusive interview with PREMIUM TIMES on January 31, the minister stressed that provision of healthcare in Nigeria is a concurrent responsibility of the three tiers of government.
Mr. Adewole appealed to the National Assembly to stop creating new PHCs so that existing ones can be put in good shape.
“We are also appealing to the National Assembly not to create more PHCs because having a building is not synonymous to a health centre. A building without human resources, equipment and drugs is not a health facility.
“Everybody wants to build a PHC in his village, but who will run it? So we are begging them to stop creating,” he said.
Mr. Adewole said the federal government’s role in healthcare delivery is mostly limited to coordinating the affairs of university teaching hospitals and federal medical centres (tertiary healthcare) while the state governments manage general hospitals (secondary healthcare) and local governments focus on primary healthcare, in line with regulation by the federal government through the National Primary Health Care Development Agency (NPHCDA).
He said it is not appropriate to hold the federal government responsible for the poor state of primary health centres in the country.
“When you say primary health care projects, are you talking about federal? Because PHC is not under us, it’s under local governments. Why we made PHC a focus is because we just have to take care of it. But normally, PHC is not the responsibility of federal government”, Mr. Adewole said during the interview.
A recent investigation by PREMIUM TIMES mirrored the terrible state of Primary Health Centres across the nation.
The federal government flagged off the Primary Healthcare Centres (PHC) revitalisation programme in January last year, under which it undertook to revitalise a centre in each of Nigeria’s 109 senatorial districts, while other levels of government and development partners would collaborate with it to bring the number of PHCs touched by the scheme across the country to 10,000.
Several months after the flag off of the scheme, all the eight primary health care centres PREMIUM TIMES visited in Niger, Benue and Nasarawa states in North Central Nigeria had no doctors, drugs or equipment.
PREMIUM TIMES also visited 12 of the facilities across Nasarawa State and found only two of them under renovation. It was not clear whether the two were among the three the federal government undertook to revitalise in the state.
When asked to explain the progress of the plan to revitalise 10,000 PHCs, the minister stressed that it was not the government alone that was involved in the exercise.
“It’s not FG that is revitalizing, what we said is that we want to see 10,000 PHCs revitalized in Nigeria because if 10,000 is done, it will cover about 100 million people.
“We only did this to stimulate the governors and many of them have taken it up. At the last count, Niger has done 40. We did three in Niger and we call them model PHCs.
“President Buhari commissioned one in Kuchingoro. In Kaduna the governor has done 255. I’ve commissioned in Kebbi, Abia and other states. What we are asking the governors to do is to invest and partner with us.
“I can also tell you as of today, the World Bank has done about 1500 PHCs. The EU is committed to 774. The British government is doing 950. FG is committed to 110 last year. This year we will do more. So, over all, we are adding them together and we will now ask the states ‘how many they’ve done, where are they located?’ We are also doing an inventory of the PHCs done by ALGON.”